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. 2020 Jun 1;8(6):e17372. doi: 10.2196/17372

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©Xu Tian, Ling-Li Xu, Xiao-Ling Liu, Wei-Qing Chen. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.06.2020.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

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Trial sequential analysis of ADR. A diversity-adjusted information size of 3644 patients was calculated using alpha=.05 (2-sided), beta=.20 (power 80%), an anticipated relative risk reduction of 20%, and an event proportion of 16.49% in the SPE arm. The TSA-adjusted 95% CI for a relative risk of 1.37 is 1.15 to 1.64 (Random effects model [DL]). TSA illustrated that the required information size was not achieved (adjusted information size=3644), however, that the cumulative z curve crossed the trial sequential monitoring boundary for benefit, showing that currently cumulative evidence is conclusive. ADR: adenoma detection rate; EPE: enhanced patient education; SPE: standard patient education; TSA: trial sequential analysis; DL: DerSimonian and Laird.